ELLSWORTH — An unprecedented rise in respiratory syncytial virus (RSV) among babies and toddlers in Maine has created what Maine pediatricians are describing as a “significant strain” on pediatric inpatient capacity across the region. RSV symptoms are similar to the common cold but can potentially create breathing problems for the youngest.
At a news conference last Friday, health experts from MaineHealth and Northern Light Health asked the public to remain vigilant in protecting themselves against respiratory illness.
“We are completely at capacity today,” said Dr. Mary Ottolini, chairwoman of pediatrics at Barbara Bush Children’s Hospital in Portland. “We are able to meet the needs of our pediatric patients in Maine, but our in-patient and outpatient capacity is stretched to the max.”
The hospitals have seen a record number of RSV patients.
These are numbers of RSV cases not usually seen before January, said Dr. Jonathan Wood, a pediatric critical care medicine specialist at Northern Light Eastern Maine Medical Center.
Ottolini added, “We’re working with Eastern Maine Medical Center and the Maine CDC to look at creative ways to increase our staffing and bed capacity. We have to postpone some non-urgent procedures such as surgeries. While we want everyone to know how stretched we are, we also don’t want parents to panic. RSV is not a new virus. It was around way before me.”
Most at risk of complications from RSV are newborns and babies under 6 months of age.
“Unfortunately, there is no treatment to keep kids from getting the virus,” the physician said. “It’s just supportive care.”
While RSV mimics a cold with a runny nose and congestion, young babies can become seriously ill.
Hospital admission due to RSV varies depending on a child’s underlying health history and conditions, according to Ottolini.
“The main reason for admission: their little airways are collapsing and they can’t get enough oxygen into their system,” Ottolini said. “Some babies progress to getting on a ventilator to breathe. If a child ends up on a ventilator, they could be in hospital for weeks. They’re very, very sick.”
Parents and guardians should contact their child’s primary care provider if the child is sick with a fever, not eating or not sleeping.
“Try to contact the primary care office first,” Ottolini said. The emergency department is needed for the sickest children. But, if the baby or child starts turning blue or starts breathing rapidly, seek emergency care.
Wood said he and Dr. Ottolini are meeting weekly with their colleagues across New England as the entire region is experiencing a jump in RSV cases, not just Maine.
“We’re boarding children in the ER, which is extremely stressful for them and their parents,” Wood said.
“We don’t want people to delay care,” Wood said. But, the practitioners want parents to do a “triage phone call with a primary care provider” about hydration, sleeping and breathing.
“Parental intuition is undervalued sometimes,” Wood said. “‘I feel this is severe,’ and that’s enough.”
“We don’t fully know why we have such a severe RSV season,” Wood said. “It’s just so many more are getting it. It probably has to do with the fact it hasn’t circulated much in the past three years. We haven’t seen RSV because COVID was crowding it out. A lot of our younger children weren’t exposed to it the past three years. We’re also seeing an uptick in influenza.”
Dr. Dora Anne Mills, chief health improvement officer for MaineHealth, said children who are at high risk should be kept away from public, indoor crowded spaces.
“If you have a newborn or a child at high risk for RSV, take precautions so you don’t get RSV and take it home,” Mills said. “Cover coughs and sneezes. Wash your hands frequently.”
“The vast majority of people who get RSV get a cold,” Mills said. “Almost everybody contracts it before the age of 5.”
“These younger children, babies under 6 months of age and newborns are at risk for these serious cases of RSV,” Mills said. “Even if you have a mild cold, stay away if you can. Put a mask on. Be very careful.”
Dr. James Jarvis, a family physician at Northern Light Eastern Maine Medical Center, brought up the issue that health-care systems are struggling as is without the RSV surge.
“All of our health systems have been challenged due to the worldwide staffing shortage,” Jarvis said. “Our long-term care and skilled nursing are short-staffed. This backs up the entire system.
“When our hospitals get backed up, our emergency rooms get backed up, so we can’t triage people in an appropriate manner.”
There’s also a shortage in the ability to transport patients from one hospital to another in a “timely fashion,” Jarvis said.
When talking about the limited number of pediatric beds, that refers to pediatric staff as well.
“Children are not little adults,” Jarvis said.
Wood added, “We have people who specialize in the physiology of a child.”
One member of the media during the press conference questioned the timing of the surge. Could it be due to the fact that Maine is now two months into the school year?
”We’ve had RSV in the summer — last summer and this summer,” Wood said. “That’s never happened in my career, seeing kids in the hospital in July.”
There’s a “shift in the way viruses are moving worldwide, not just nationwide or New England-wide,” Wood said. “We’re ‘off’ in terms of the respiratory season. I’m not stunned by it. I couldn’t have predicted it, but it doesn’t surprise me, given what we’ve seen the past 24 to 36 months.”
The trend is “fascinating for epidemiologists or microbiologists but a pain in the neck for the rest of us,” Wood said.
The physicians encourage everyone to get a flu shot.